MONDAY, Sept. 24 (HealthDay News) -- More and more children are
growing up with autism, and although many treatments and
interventions are now available, clinical studies on the use of
medications in teens and young adults are lacking, according to new
research.
"The majority of (older) individuals with autism spectrum disorders appear to be taking medications that we have very little evidence for," said the study's lead author, Dr. Jeremy Veenstra-VanderWeele, medical director of the Treatment and Research Institute for Autism Spectrum Disorders at the Vanderbilt Brain Institute in Nashville, Tenn.
"In the absence of sufficient evidence, parents and people with autism should find a clinician who tells you what's known and unknown about the potential benefits and risks of any medication," he said. "It should be a shared decision-making process."
Results of the study were published online on Sept. 24 in the
journal
Pediatrics.
Autism spectrum disorders are neurodevelopmental disorders that
impair social development and communication. Autism spectrum
disorders also may cause repetitive movements and even self-abusive
behavior, such as head banging, according to the U.S. National
Institute of Neurological Disorders and Stroke (NINDS).
It is estimated that about one in 88 American children has been
identified with an autism spectrum disorder
As children with autism age, some do experience significant
improvements, according to NINDS, but many do not. There is no cure
for autism, although there are many treatments available, including
education and behavioral interventions and medications.
Medications usually are used to treat some of the symptoms
associated with autism, rather than the core symptoms of the
condition, according to background information in the new study.
For example, the medication risperidone (brand name Risperdal) may
be used to treat behavioral symptoms associated with autism, such
as aggression, outbursts and irritability, said Dr. Melissa
Nishawala, medical director of the Autism Spectrum Disorders
Clinical and Research Program at the NYU Child Study Center in New
York City.
"Medications like risperidone and aripiprazole don't address the cause of autism, but they help calm down [people with autism]," Veenstra-VanderWeele said.
For the new study, the researchers reviewed medical literature
from 1980 through 2011 to find clinical trials on drugs for people
with autism between the ages of 13 and 30 years old. They found
eight studies with at least 20 participants. Two investigators
independently assessed the quality of the studies.
The researchers said they found four studies of fair quality
while the other four were poor. The studies included reviews of
antipsychotic medications, such as risperidone and haloperidol
(Haldol); serotonin reuptake inhibitors, such as fluvoxamine
(Luvox) and clomipramine (Anafranil); and opioid receptor
antagonists, such as naltrexone (Depade).
The researchers felt that, overall, there wasn't enough data on
medications in the teen and young adult autism population.
Risperidone wasn't well studied in teens and young adults, but
there was evidence for its use if the entire pediatric population
was considered, the study said.
Although behavioral and educational interventions weren't
included in the new study, Veenstra-VanderWeele said he suspects
there's a lack of evidence for these types of treatments in older
children and young adults too.
"We really don't know if intensive behavior interventions continue to benefit individuals as they get older," he said.
NYU's Nishawala said: "The most important thing for parents to
take away is that we know there are a few medications that have
been studied that can help. Certain symptoms like irritability,
agitation and aggression can be controlled with medications, but
there's lesser evidence that repetitive behaviors can be
treated."
Nishawala added that although she and others who treat older
children and young adults with autism would love to have more
evidence-based research on the medications they use, it can be
difficult to get parents and older children to participate in
clinical trials when medications are already available to them for
what's known as "off-label" use. That's when doctors prescribe
medications for a condition for which the drug has yet to receive
U.S. Food and Drug Administration approval.
In addition, she said, it's difficult to get funding for trials,
particularly when a drug already has been approved.
More information
Learn more about autism and teens from the
Nemours Foundation.